ProPeer Resources, LLC Achieves HITRUST CSF® Certification to Further Mitigate Risk in Third-Party Privacy, Security, and Compliance

NEW BRAUNFELS, Texas, April 1, 2020 – ProPeer Resources, LLC a leading provider of independent reviews, today announced their physical and virtual servers, desktop computers, and network infrastructure used to support independent medical peer review services has earned Certified status for information security by HITRUST®. HITRUST CSF Certified status demonstrates that the organization’s physical and…

Nexus Certified as Service-Connected Disabled Veteran Owned Business (SDVOB)

New Braunfels, TX, March 4, 2020 – Nexus, a Texas-based clinical review organization, has been awarded the prestigious Service-Connected Disabled Veteran Owned Business (SDVOB) Certification by the National Veteran Business Development Council.   Veteran focused Diversity Spending Programs are an $80 billion-dollar market in the United States. As the leading certification agency, NVBDC is a…

Nexus to Participate in Compliance & Ethics Week 2019

  Nexus Enterprises, LLC specializes in providing Utilization Management and clinical review services to the Workers Compensation and healthcare industry. We are delighted to once again participate in Corporate Compliance & Ethics Week with a kick-off breakfast for all staff to meet and greet with the Nexus Privacy and Security Compliance Officers. During the week…

Nexus Announce to be the Official WIFI Sponsor of 2019 Workers’ Compensation and Disability Conference & Expo

Nexus is proud to announce we will be the official WIFI Sponsor of the 2019 Workers’ Compensation and Disability Conference & Expo November 6-8 at the Mandalay Bay in Las Vegas.  Visit our team at booth 2149! Find more event details here!   About National Workers’ Compensation and Disability Conference The National Workers’ Compensation and…

Nexus Earns Certified Veteran’s Business Enterprise™ Designation from the National Veteran Owned Business Association

    For Immediate Release:  Economic News: Veteran-Owned Businesses New Braunfels, Texas, September 6, 2019 – Nexus is proud to announce that it has earned the exclusive designation as a Certified Service-Disabled Veteran’s Business Enterprise™ (SDVBE) from the National Veteran-Owned Business Association. To be eligible for the designation as NaVOBA Certified SDVBE™, the applicant firm…

Nexus Announces Corporate HQ Relocation

Austin, TX –  Newmark Knight Frank (NKF) announces a new build-to-suit lease has been secured between Nexus and CCD Enterprise Acquisition, the owner of 5600 Schertz Parkway in Schertz, Texas. Nexus will occupy the single-story, tilt-wall-construction office building, measuring 36,450 rentable square feet. NKF Associate Director Scott Lewis represented Nexus on the build-to-suit lease transaction.…

Nexus Announces Appointment of Gordon Breslav as Senior Vice President of Business Development

NEW BRAUNFELS, Texas, March 25, 2019 /PRNewswire/ Nexus is pleased to announce that Gordon Breslav has been appointed Senior Vice President of Business Development for Nexus and its subsidiaries. In this role, Gordon will lead all aspects of the national sales and marketing efforts to drive long-term strategic growth for both Nexus’s utilization management and…

Imposter Ex-Surgeon Defrauds Independent Review Organizations Impacting Thousands of Claims Nationwide

King v. CompPartners. Spyros Panos. Mega-mergers. 2018 has proven to be a monumental year with unprecedented litigation and events profoundly jolting the foundation of the Utilization Review market. These epic events, each holding different significance and impact, have irreversibly changed the landscape and evolution of Independent Review Organizations and Utilization Review Organizations nationwide. No event…

URAC Awards Nexus Reaccreditation for Workers’ Compensation Utilization Review

11/01/2018 – New Braunfels, Texas – Nexus, a national leader in independent clinical review, has earned URAC reaccreditation in Workers’ Compensation Utilization Management. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, Nexus has demonstrated a comprehensive commitment to quality care, improved processes and better patient…

ProPeer Resources Awarded URAC Reaccreditation for Independent Review Organization: Comprehensive Review (Internal & External)

CENTERVILLE, Utah, July 11, 2018 /PRNewswire/ — ProPeer Resources, a leading national clinical review organization, announced today it has been reaccredited by URAC for the Independent Review Organization: Comprehensive Review (Internal & External) standards.  The URAC accreditation process demonstrates a commitment to quality services and serves as a framework to improve business processes through benchmarking organizations…

Nexus to Host Keynote Breakfast at 2017 National Workers’ Compensation and Disability Conference

Nexus is pleased to announce our participation as an exhibitor and sponsor at the 2017 National Workers’ Compensation and Disability Conference. This year’s NWCDC exhibition will be held at the Mandalay Bay Conference Center and Resort in Las Vegas. We hope you will join the Nexus team as we host the sponsored Keynote Breakfast opening…

Corporate Compliance & Ethics Week

Nexus will be participating in the national Corporate Compliance & Ethics Week, November 5-11. This week-long celebration of compliance and ethics is a great opportunity to shine a spotlight on the importance of compliance and ethics for organizations nationwide. Companies across the country utilize this designated week for compliance staff to build awareness in ways…

Reviewer Anonymity Remains Threatened as IROs Grapple with Personal Disclosures

“Consumer education is a key element in understanding the role of an Independent Review Organization and what a medical provider may or may not be responsible for in the review process. Reviewer anonymity is a critical factor in protecting the independent and unbiased status of the medical reviewer in the IRO/appeals process.” — Ed Bolton,…

NAIRO names Nexus CEO, Vice President of the Executive Committee

NAIRO officially appointed three prominent industry experts to key posts this May. One of the three executives assuming leadership positions on the NAIRO board is Nexus CEO, Ed Bolton. Mr. Bolton, who previously served as Chair of NAIRO’s Membership and Marketing Committee, will be taking over as Vice President of the Association. Mr. Bolton has…

Risk Revolution: 2017 RIMS

The Nexus team will be headed to Philadelphia to attend the 2017 RIMS Conference April 22-27th at the Pennsylvania Convention Center. The RIMS 2017 Annual Conference & Exhibition is the premier industry four-day event that offers more than 100 educational sessions and keynote presentations. Over 10,000 risk professionals, business executives, risk managers, brokers, insurers, employers…

Florida Approves 14.5% Workers’ Comp Rate Hike in Response to Court Rulings

The Florida Office of Insurance Regulation (OIR) has given contingent approval for an overall statewide workers’ compensation rate increase of 14.5 percent to take effect Dec. 1, 2016. The rate increase is in response to two recent Supreme Court rulings undoing reforms passed in 2003 and rocking the state’s workers’ compensation system. In the Sept.…

Report: Alabama No. 1 in Country for Prescription Opioid Use

Alabama has the highest level of prescription opioid use in the country, and companies that make the painkillers and their allies have hired an average of 18 lobbyists annually in the state since 2006 to push their policies. A joint investigation by The Associated Press and the Center for Public Integrity found that companies that…

Only 11 Medicaid managed-care plans have more than 1 million members

Consolidation in the insurance industry means Medicaid beneficiaries have fewer coverage options under managed care, according to a new analysis from PWC. Following the 26% growth in Medicaid over the past two years due, in part to expansion under the Affordable Care Act, 75.2 million Americans, or 23.4% of the nation’s population, are now enrolled…

The Essence of Servant Leadership

What is servant leadership? How can you benefit from it? Serving at its core meaning is setting aside your own needs and desires, in order to aid or assist others with their needs. Notice I did not mention “wants”, it is all about helping others achieve their legitimate needs. The benefits to you are endless.…

Dennis Tierney: If Properly Conducted, Claims Reviews can be an Effective Tool to Manage Workers’ Comp Claim Costs

By Dennis Tierney, Senior Vice President, Director of Workers’ Compensation Claims, Marsh In the many meetings, forums, and conferences that I attend throughout the year, one question consistently gets raised and discussed between insureds, insurers, brokers and claims professionals: Is there value to conducting a claims review? It is a question that seems to have…

Cybersecurity Is Every Executive’s Job

All companies connected to the internet are vulnerable to cyber attacks. And the potential losses are significant. Retail giant Target, for example, estimated its losses from a 2013 data breach at more than $250 million. What’s more, according to a recent survey conducted for BAE Systems of 300 managers in the financial services, insurance, and…

Aetna is notifying some doctors about their drug-dispensing habits

Many experts say the prescription painkiller epidemic started when physicians began over-prescribing powerful opioid medications, a well-meaning attempt to more aggressively treat patients’ pain. With addiction to those pills at crisis levels, they argue, a good part of the solution would be for doctors to rein in use of the drugs. The giant health insurer…

In Age of Mergers, Healthcare Providers Look for New Ways to Improve Care and Cut Costs

Hospitals and patient care centers aren’t typically bought and consolidated as much as other healthcare companies, but new ideas and regulations on care have spurred a flurry of deals. “Mergers are accelerating, and we’re seeing all varieties of it,” said Julie Coffman, a partner with Bain & Company, a global business consulting firm that specializes…

Employers Project Health Premium Hike of 6% in 2017

Health care benefit cost increases at large U.S. employers are expected to hold steady at 6 percent in 2017. The good news is that health premiums are not growing at a faster clip year after year, as they were a decade ago. The bad news is that the increase in health plan costs still outpaces…

CURES Mandate One Step Closer

UPDATE on Aug 25 – Once the votes were officially recorded late last night, the “no-votes-recorded” all clarified their position to be Aye’s. So the impressive 73-0-7 is noweven more impressive – 80-0! If you want to see for yourself, since that kind of bipartisan and unanimous vote doesn’t happen very often, here’s the final…

Talent Attraction, Training and Retention in the Workforce

Talent attraction, retention and training are among the industry’s most promising opportunities and an influx of new professionals is paramount to the long-term success of our business. In this session at WCI’s 2016 Workers’ Compensation Educational Conference, executive leaders in the industry shared their perspectives on what they believe will be the necessary skill sets…

NAIRO Releases Solutions to Prevailing Barriers Facing Health Care’s Independent Medical Review Process

July 29, 2016 New white paper enumerates key challenges – and solutions – to a core function of health care July 29, 2016 – Today the National Association of Independent Review Organizations (NAIRO) released a set of guidelines outlining the path forward for an optimally functioning independent medical review process, a key component of evidence-based…

NAIRO Educational Symposium October 12

Join Healthcare and Regulatory Thought Leaders for the NAIRO Educational Symposium On October 12th, NAIRO will be hosting its 2nd Annual Educational Symposium in Washington, DC. Who Should Attend? Anyone in the healthcare industry will benefit from attending this premier event which is slated to draw together healthcare providers, physicians, executives, legislators, Utilization Management Organizations,…

Ensuring Accuracy in Medicine by Texas Homes for Sale

Nexus Medical™ Consulting recently had an article written by Elisha Neubauer from Texas Homes for Sale about the company. The piece dove into the impact Nexus has on the efficiency of health care being currently delivered  in America. Click below to read the full article >> We were recently featured on Texas Homes for Sale, one of the…

Accreditation required in CO in order to review prior authorizations

Changes in the CO DWC Rule 16 – Utilization Standards.  The new rules, effective 01/01/16, require peer reviewers to be either Level I or Level II Accredited with DWC in order to review prior authorization requests for medical reasons. The difference between the two levels is that Level II Accreditation allows providers to perform impairment…

National Work Comp and Disability Conference

We will be at the National Work Comp and Disability Conference at the Mandalay Bay Resort & Conference Center!  We would love to meet you and share solutions for all of your Work Comp and Disability needs.   Join us for the Nexus sponsored Continental Breakfast on Thursday, 11/12/2015 from 7:45am – 8:30am.  This will be…